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昝军民,金彩丽,李雅丽,汤海军.品管圈在降低医院抗菌药物使用强度的应用研究[J].中国医药科学,2023,(4):130-134        基金项目:甘肃省定西市优秀科技成果项目(20210185)
品管圈在降低医院抗菌药物使用强度的应用研究
Application research of quality control circle in reducing the usage intensity of antibacterial drugs in hospital
  
DOI:
中文关键词:  品管圈;抗菌药物;使用频率;使用强度;应用研究
英文关键词:Quality control circle; Antibacterial drugs; Usage frequency; Usage intensity; Application research
作者单位
昝军民,金彩丽,李雅丽,汤海军 甘肃省定西市人民医院临床药学科,甘肃定西 743000 
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中文摘要:
      [摘要] 目的 探讨利用品管圈在降低医院抗菌药物使用强度的效果。 方法 将定西市人民医院开展品管圈活动前2020年1—12月的病历数据作为对照组,将开展品管圈活动后2021年1—12月的病历数据作为观察组;比较开展品管圈活动前后院内抗菌药物不合理使用情况、预防性抗菌药物使用情况及抗菌药物强度情况。并在开展品管圈活动前后对“圈员”进行药方审核、抗菌药物使用原则及相关疾病用药准则等方面的评估;随机选取30名不同科室临床医师,对抗菌药物使用原则、相关疾病用药准则方面进行评估,并对药方审核方面满意度进行评价。 结果 经品管圈活动后,2021年的抗菌药物使用强度由2020年的37.97 DDDs/100人天降为35.86 DDDs/100人天;治疗前微生物送检率由42.58%(511/1200)提升为56.58%(679/1200),差异有统计学意义(χ2=47.043,P < 0.001)。观察组预防性抗菌药物率为27.00%(135/500),低于对照组的53.00%(265/500),差异有统计学意义(χ2=70.417,P < 0.001)。观察组预防性给药时机在术前0.5~1.0 h的占比高于对照组,药物选择不合理率低于对照组,预防用药时间在≤24 h中比例高于对照组,差异有统计学意义(P < 0.05);两组第二代头孢菌素、第三代头孢菌素、糖肽类药物使用率比较,差异无统计学意义(P > 0.05);观察组第一代头孢菌素、喹诺酮类、林可胺类药物的使用率低于对照组,差异有统计学意义(P < 0.05);观察组头霉素类药物的使用率高于对照组,差异有统计学意义(P < 0.05)。开展品管圈活动后,“圈员”在药方审核、抗菌药物使用原则及相关疾病用药准则的水平较开展前均有所提高,差异有统计学意义(P < 0.05);开展品管圈活动后,临床医师在抗菌药物使用原则及相关疾病用药准则的水平较开展前均有所提高,且对药方审核满意度有所提高,差异有统计学意义(P < 0.05)。 结论 品管圈活动的开展有效降低我院抗菌药物的使用强度,提高抗菌药物的使用合理率,同时对临床医师及药师的业务水平也有所提升,有效提高整体药物管理质量。
英文摘要:
      [Abstract] Objective To investigate the effect of using quality control circle (QCC) in reducing the usage intensity of antibacterial drugs in hospital. Methods The medical records data of Dingxi People’s Hospital from January to December 2020 before the QCC activities were selected as the control group, and the medical records data from January to December 2021 after the QCC activities were selected as the observation group. The irrational usage of antibacterial drugs, the usage of prophylactic antibacterial drugs and the intensity of antibacterial drugs before and after the QCC activities were compared. Before and after carrying out the QCC activities, the "circle members" were evaluated in terms of prescription audit, usage principles of antibacterial drugs and drug usage guidelines for related diseases. 30 clinicians were randomly selected from different departments to assess the usage principles of antibacterial drugs and drug usage guidelines for related diseases, and to evaluate the satisfaction of prescription audit. Results After the QCC activities, the usage intensity of antibacterial drugs in 2021 decreased from 37.97 DDDs/100 person-days in 2020 to 35.86 DDDs/100 person-days. Compared with that before treatment, the microbiological examination rate increased from 42.58% (511/1200) to 56.58% (679/1200), with statistically significant difference (χ2=47.043, P < 0.001). The rate of prophylactic antibacterial drugs in the observation group was 27.00% (135/500), lower than 53.00% (265/500) in the control group, with statistically significant difference (χ2=70.417, P < 0.001). In the observation group, the proportion of preventive medication time in 0.5-1.0 h before operation was higher than that in the control group, the irrational rate of drug selection was lower than that in the control group, and the proportion of prophylactic drug time in≤24 h was higher than that in the control group, with statistically significant differences (P < 0.05). There were no statistically significant differences in the usage rates of second-generation cephalosporins, third-generation cephalosporins and glycopeptides between the two groups (P > 0.05). The usage rates of cephalosporins, quinolones and lincosamides in the observation group were lower than those in the control group, with statistically significant differences (P < 0.05). The usage rate of cephamycin drugs in the observation group was higher than that in the control group, with statistically significant difference (P < 0.05). After carrying out the QCC activities, the level of the "circle members" in terms of prescription audit, usage principles of antibacterial drugs and drug usage guidelines for related diseases was improved than that before the QCC activities, with statistically significant difference (P < 0.05). After carrying out the QCC activities, clinicians' level of usage principles of antibacterial drugs and drug usage guidelines for related diseases was improved than that before the QCC activities, and their satisfaction with prescription audit was also improved, with statistically significant differences (P < 0.05). Conclusion The conduct of QCC activities effectively reduces the intensity of the usage of antibacterial drugs in our hospital, increases the rational rate of the usage of antibacterial drugs, simultaneously improves the professional level of clinicians and pharmacists, and effectively enhances the overall drug management quality.
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关键词: 中国医药科学 中国医学 中国医学科学 中华医学 医学杂志 临床医学杂志 医学期刊 中国预防医学 中华预防医学 预防医学杂志 中国药学 药学杂志
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